Network Account Manager

3 days ago

Plano, Texas, United States Zelis Healthcare Full time
Job Summary

We are seeking a highly skilled Network Account Manager to join our team at Zelis Healthcare. As a key member of our Network Solutions team, you will be responsible for managing designated leased network partner relationships within an assigned book of business. Your primary goal will be to retain existing business, identify growth opportunities, and optimize revenue.

Key Responsibilities
  • Lead regular check-ins with network partners to maintain open communication and address any issues or concerns.
  • Provide timely updates on network performance and utilization to ensure proactive management of any changes in volume.
  • Develop and maintain implementation guides for assigned networks to foster retention and drive growth.
  • Analyze network utilization on a quarterly basis to identify areas for improvement and mitigate any potential risks.
  • Ensure accurate and up-to-date rate management for each assigned network partner, aligning with client contracts and published rate sheets.
  • Identify and escalate potential risks, such as volume decreases, service gaps, or changes in network-level relationships, to the VP of Network Solutions.
  • Develop a deep understanding of network expectations, objectives, initiatives, and opportunities for growth.
  • Clearly communicate the value proposition of Zelis products and services to network partners.
  • Stay abreast of changing healthcare landscape, regulations, and related health plan/payer trends.
  • Collaborate with Project Management and Business Support teams to ensure seamless implementation of new networks.
  • Request network approval for new clients and communicate with the Client Setup Team.
  • Partner with Strategic Account Management, Client Services, EDI Teams, and Accounting to address client/network partner needs.
  • Coordinate with Zelis Third Party Risk Management for network discussions and policy reviews.
  • Participate in Network Solutions meetings to stay informed and contribute to team discussions.
  • Maintain current knowledge of network partners' rules of engagement and provide consultation and assistance to team members as needed.
  • Ensure adherence to Zelis standards regarding privacy and security.
Requirements
  • Foundational knowledge of Zelis product portfolio, implementation process, and overall strategy of Zelis Network Account Management.
  • Proven work experience as an Account Manager, Key Account Manager, Sales Account Manager, or relevant role.
  • Demonstrable ability to communicate, present, and influence key stakeholders at all levels of an organization, including executive and C-level.
  • Developed knowledge of assigned network base.
  • Demonstrated ability to retain and maximize existing block of business.
  • 8+ years' experience working with/for Health Insurance companies, TPAs, or PPO Networks in account management or similar role.
  • Strong communication skills; ability to synthesize complex issues and communicate clearly to both network partners and internal stakeholders.
  • Proven ability to juggle multiple account management projects at a time, while maintaining sharp attention to detail.
  • Thorough knowledge of Excel and other MS Office products.
  • Experience utilizing Salesforce or other CRM tool.
About Zelis Healthcare

Zelis Healthcare is a leading payments company in the healthcare industry, guiding, pricing, explaining, and paying for care on behalf of insurers and their members. We partner with over 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs, and self-insured employers, to deliver a better financial experience and more affordable, transparent care for all.

We foster a hybrid and remote-friendly culture, with offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. Our employee's work locations are based on the needs of the position and determined by the Leadership team.

We are committed to diversity, equity, inclusion, and belonging in all aspects of our operations. We create an environment where people can bring their authentic and best selves to work, and we know that a sense of belonging is key to success at Zelis Healthcare.

We are proud to be an equal opportunity employer, and all applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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